A new clinical approach to improve the appropriate use of peripherally inserted central catheters: a prospective study

Buisson, Marlène; Leguelinel, Géraldine; Bastide, Sophie; Beregi, Jean Paul; Kinowski, Jean-Marie; Frandon, Julien; Chasseigne, Virginie

doi:10.1136/ejhpharm-2020-002483

Cited by 1 publication

(7 citation statements)

References 9 publications

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“…The pharmacist’s role was to discuss all inappropriate PICC requests by reviewing ongoing and future treatments, exploring options for adjusting the medication plan, and discussing the device option with the ordering physician. In our study, all PICC requests were analyzed by the pharmacist who could (1) validate the request, (2) ask the ordering clinician to modify the request (e.g., single-lumen PICC), or (3) cancel the request in agreement with the radiologist and the ordering physician if the PICC was inappropriate 11 . As our center was inserting approximately 1500 PICCs a year, requested by more than 20 different medical units, the CP, with his/her clinical and technical skills and transversal vision of the PICC circuit, seemed the best choice to perform this task.…”

Section: Discussionmentioning

confidence: 99%

“…Multidisciplinary meetings with professionals implicated in the circuit (physicians, radiologists, pharmacists, technicians, nurses, and computer engineers) were held, and a computerized PICC request with blocking items was developed. Standardized pharmaceutical interventions for the validation of a PICC request were created as described in our previous study 11 . The study started after a period of 8 months (from February 2017 to September 2017) during which the online requests and the CP intervention was set-up and deployed, and staff trained.…”

Section: Methodsmentioning

confidence: 99%

“…For this, several sources were used: the MAGIC criteria, national recommendations and compatibility analysis tools 5,13,14 . If any nonappropriate PICC requests made (e.g., wrong PICC number of lumens), the pharmacist could asked the physician to exchange the device for single or double-lumen PICCs 11 …”

Section: Methodsmentioning

confidence: 99%

“…Standardized pharmaceutical interventions for the validation of a PICC request were created as described in our previous study. 11 The study started after a period of 8 months (from February 2017 to September 2017) during which the online requests and the CP intervention was set-up and deployed, and staff trained.…”

Section: Study Design and Patientsmentioning

confidence: 99%

“…To improve and ensure appropriateness of PICC use, we have added in our institute the intervention of a clinical pharmacist (CP) in the PICC prescription process. 11 Peripherally inserted central catheter requests are now computerized, and each request is analyzed and validated with regard to the patient's clinical condition and treatments by a CP, as part of clinical routine. Special attention is now paid to the number of lumens ordered for PICC insertion.…”

mentioning

confidence: 99%

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Pharmaceutical Analysis of Peripherally Inserted Central Catheter Requests Increases the Use of Single-Lumen Catheters: A Prospective Pilot Study

Chasseigne

Buisson

Serrand³

et al. 2022

J Patient Saf

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Objectives: Several studies have suggested a strong relationship between the number of peripherally inserted central catheter (PICC) lumens and the risk of complications. The purpose of this study is to evaluate the impact of the intervention of a clinical pharmacist (CP) on the number of lumens of PICC inserted and assess PICC-related complications.Method: This prospective monocentric study included all consecutive patients from 5 different units who underwent PICC insertions from September 2017 to March 2018. In the intervention group, the CP validated the pertinence of each PICC request according to the patients' records, choice of device (single or double lumen), and incompatibilities between treatments. The control group consisted of patients who underwent PICC insertions without a CP intervention. Complications were prospectively recorded up to PICC removal. Multivariate analyses adjusted for sex, age, and PICC line duration were performed.Results: In the intervention group, 207 PICCs were inserted, 81.2% (n = 168) were single-lumen devices and 18.8% (n = 39) were double-lumen devices. In the control group (n = 77), the use of single-lumen PICCs was significantly lower (n = 48, 62.3%; P = 0.002). After intervention, the overall complication incidence rate decreased from 4.42 to 3.23 per 1000 catheter days ( P = 0.082). Considering the overall population, 216 single-lumen PICCs were inserted with significantly fewer complications than double-lumens (respectively n = 16, 16/ 216 = 7.4%, versus n = 15, 15/68 = 22.1%, P = 0.002). The adjusted odds ratio of double-lumen PICC was 3.83 (95% confidence interval, 1.46-10.07; P = 0.007).Conclusions: Our study showed the intervention of a CP in the PICC insertion process could increase the use of single-lumen PICCs and tended to reduce associated complications.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%